Ask An Expert / Elimination Disorders

My 7-year-old daughter keeps wetting her pants at school. What should we do?

A behavioral therapist should be able to help

Laura Kirmayer, PhD, MSW

Laura Kirmayer, PhD, MSW

My seven-year-old daughter was toilet trained at four, but continues to wet her pants. We thought this was mostly occurring at home, but today one of her elementary school teachers took me aside to report that it has been continually happening in the classroom. When confronted, she usually denies it or doesn't want to discuss it.

Initially, our pediatrician advised us not to make a big deal about this behavior. His rationale was that peer pressure and more emotional maturity would eventually solve the problem. Well, this approach has failed.

This can't be positive from a social perspective. If you can give us some advice on strategies to change this behavior, we would be very grateful.

It sounds like your daughter might be struggling with something called enuresis. Since you’ve already gone to a pediatrician to rule out any medical causes, your next step should be to see a behavioral therapist who works with young kids. Since your daughter is likely holding her bladder all day at school, her therapist should perform a thorough assessment to determine why. She could be having difficulty with sensing when she needs to go to the bathroom, difficulty with attempting, or possibly some kind of anxiety. Fortunately there are some really straightforward and evidence-based behavioral treatments that should help her with toileting and also help her regain her confidence.

Finally, you are absolutely right that the longer you wait this could be negatively impacting her socially and emotionally, so the sooner you meet with a therapist and start an intervention the better.